MEDICARE: SAIMONE SANDRA SAILOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	172A00000X	Driver
2	251E00000X	Home Health Agency
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1477183788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAIMONE SANDRA SAILOR

Provider Business Mailing Address
First Line	:	2589 PINE CREEK RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-4335
Country	:	US
Telephone Number	:	702-289-5267
Fax Number	:

Provider Business Practice Location Address
First Line	:	2589 PINE CREEK RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-4335
Country	:	US
Telephone Number	:	702-289-5267
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2020
Last Update Date	:	01/26/2020

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Directions to “ SAIMONE SANDRA SAILOR ” Practice Location

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